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Please Help

  1. #1
    Default Please Help
    Medical Coding Books
    When a procedure is converted from a laparscopic procedure to an open one, wouldn't we use an open procedure code? Or would we use the lap procedure code with V64.41?
    Thank you,
    Colleen R Cox CPC

  2. #2
    Location
    Seacoast- Dover New Hampshire
    Posts
    609
    Default
    I would use the lap with the 53 then used the open
    Karen Barron, CPC
    Hampton New Hampshire Chapter

  3. Default
    we use the open code with v64.41 as the second diagnosis.

  4. #4
    Default
    Quote Originally Posted by kbarron View Post
    I would use the lap with the 53 then used the open
    Mod 53 is only to be used when a procedure is discontinued because a threat to patients life. Like if patient's BP went way down during procedure and it had to be stopped.

    As for yor question it depends on the procedure done. Look it up in the CPT and read the notes around it and in the beginning of that section to see if there are notes regarding this situation and if not I'd assume you'd just use the open code as billing both says you did both.
    Brittany Purcell, CPC

  5. #5
    Default
    It might depend on your procedure.

    I was running scenarios in my head and the one I have most commonly seen coverted to an open is gallbladder.

    When I run 47562-53 and 47600, my claim scrubber tells me these are bundled and a modifier is not allowed.

    My point is, this procedure is usually converted because there is a threat to the patient and the lap procedure has to be discontinued. If they nick something, they are probably going to have to open them up to fix it. So I can see where 53 might apply. Have I ever billed procedures like that, no, I am just saying Karen may have a valid point depending on the procedures.

    Just my 2 cents,

    Laura, CPC, CEMC

  6. #6
    Location
    Columbia, MO
    Posts
    12,527
    Default
    Iwas taught and remember reading somewhere but cannot remember where that:
    you cannot report a discontinued and a completed procedure to gether on the same claim, only the completed procedure gets reported. Also when you report the completed procedure you do not use the V64.x dx code as that is the code to use as a secondary dx code when you report only discontinued procedures. If documentation supports something unusual then you might be able to use a 22 modifier on the open code but they say not just because the procedure was converted but because documentation supports something extensive or unusual.

    Debra A. Mitchell, MSPH, CPC-H

  7. Default
    v64.4x is not for discontinued procedures, it is for conversion from lap to open.

  8. #8
    Wink Thank You
    It is wonderful to have so much knowledge in one place.
    Sincerely,
    Colleen R Cox CPC

  9. #9
    Location
    Columbia, MO
    Posts
    12,527
    Default
    Quote Originally Posted by heathermc View Post
    v64.4x is not for discontinued procedures, it is for conversion from lap to open.
    Ah yes you are correct I looked at the wrong code, I must get a new pair of eyes!

    Debra A. Mitchell, MSPH, CPC-H

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